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Washington Chapter - New Start Grant Application                          

     Boys High School Team                    (check one)                          Boys Middle School Team

The Program

The Washington Chapter of US Lacrosse New Start Program is intended to provide a free equipment package to qualifying new boys lacrosse teams in Washington State.  Requests must be completed and returned by December 31st, 2001.  Notification of grant awards will be made in early January.  The package includes:  2 Goals and Nets, 5 Sticks, and 5 Gloves (or other gear depending upon availability).  Please note that all new teams must have a Head Coach at time of grant application.  Head Coach must be a current member of U.S. Lacrosse or provide a copy of U.S. Lacrosse membership application at time of grant request.

Questions?                              New High School Teams           Kris Snider - 206-285-8797

                                                New Middle School Teams        Matt Hipps - 206-320-9233

 

                                                                                                                                               

Applicant Name* (please print clearly)          Applicant Role* (Head Coach, Parent coordinator, etc.)                                                                    

 

                                                                                                                                               

Applicant Address*                                                                             City*                         Zip Code*

 

                                                                                                                                               

Applicant  Home Phone*                                   Work Phone*                                    E-Mail Address*

 

                                                                                                                                               

Team Name*                                                     School(s) Represented*                Home Field Name

 

                                                                                                                                               

Head Coach* (if different from above)                     Phone # *                                   E-mail Address*

 

U.S. Lacrosse Membership # *                         

 

Have you attended League meetings?   Y  /  N  

 

How many players currently committed to play?                         

 

Description of your program: On the back of this form, please provide a description of your new lacrosse program and the need for this equipment grant. *

 

                                                                                                                                               

Additional Comments

 

                                                                                                                                               

Applicant Signature                                                                                                      Date

 

 

Please return this application by 12/31/01 to:      Gail Shelton

                                                                        U.S. Lacrosse Chapter Secretary

                                                                        8761 Island Heights Lane

                                                                        Mercer Island,  WA  98040

* required information                                         206-232-7000

 

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